In Quneitra and Dara’a, according to one source, the Russian and Syrian governments did not allow aid workers to be evacuated to Idlib.414
The systematic information campaign against the White Helmets and earlier experiences of the capture of White Helmets after the fall of Aleppo at the end of 2016 led the organisation to undertake a major evacuation of White Helmets and their families via Israel to Jordan in July 2018.415
On 1 March 2019, the OPCW confirmed that an investigation had shown that chemical weapons were used in the 7 April 2017 attack on Douma.416 Research teams from BBC Panorama and BBC Arabic investigated in detail 164 reports of chemical attacks in the period 2014 to 2018. In total, they found evidence of 106 attacks, all but three of which were carried out by the Syrian government. The other poison gas attacks are thought to have been carried out by rebel groups.417
According to the think tank Chatham House, nothing frightens people more than chemical weapons. When they are deployed, the population flees – and rarely returns in the short term.418
Syrian authorities, causing humanitarian organisations to be repeatedly denied access to certain sections of the population.421
In 2018, as a result of conflicts and local reconciliation agreements in former
opposition areas such as eastern Ghouta and the north of Homs province, more than 550,000 newly displaced people moved to opposition areas in the provinces of Idlib, Aleppo and Hama.422 This has led to an unprecedentedly high concentration of people in a limited area with limited capacity for service provision. Some IDP camps had an occupancy level of 120% at the end of 2018. It is estimated that by the end of 2018, nearly four million people were living in north-western Syria, including nearly three million in opposition areas in Idlib, western Aleppo province, northern Hama province, and eastern Lattakia province. Of the 1.9 million displaced persons, 417,501 were living in 336 IDP camps.423
At the end of November 2018, more than 12,000 IDPs from Afrin were sheltering in empty houses in villages. More than 83,730 IDPs were receiving support from five UNHCR partner organisations: the Syria Society of Social Development (SSSD), Al Ihsan, Namma, SARC Human Support Project (HSP) and Syria Trust.424
The crisis has greatly impaired Syrians’ ability to provide for themselves, and at least four-fifths of the population lives below the poverty line.425 There are serious humanitarian needs across the country, but at the end of the reporting period, the situation in north-western Syria (Idlib), in north-eastern Syria (Al Hol camp), in the south-west and around the Rukban camp was particularly concerning.426 The sharp escalation of the situation around Idlib led to large-scale displacement and
increasing numbers of dead and injured. More than 270,000 civilians were displaced and more than 160 killed between 1 and 22 May.427 During the bombing, an
estimated 20 hospitals and health facilities and 25 schools were hit. In the south of the province of Idlib and around Aleppo and Hama, some NGOs had to suspend their activities due to the high level of insecurity or the fact that the relief workers had themselves become displaced.428
In December 2018, according to Unicef, 5.6 million children were in poor conditions in Syria as a result of the civil war in a total population of 18.4 million. During this period, according to Unicef, more than 2.5 million Syrian children registered by UNHCR were out of the country, out of a total of nearly 5.7 million Syrians
421 After 92,000 civilians left or were evacuated from eastern Ghouta in March 2018, about 77,000 civilians were accommodated in tent camps in the province of Damascus. UNHCR, Syria Factsheet (January - November 2018), 31 December 2018.
422 In November 2018, around 40,000 displaced persons from the provinces of Homs, Hama and Aleppo moved to the province of Idlib after bombing along the front line of the demilitarised zone. The provision of humanitarian aid was hampered by armed groups and local authorities, insecurity and crime. UNHCR, Cross-Border Humanitarian Response Fact Sheet - Northwest Syria - December 2018, 31 December 2018. OCHA, Turkey/Syria: Cross-Border Humanitarian Reach and Activities from Turkey - November 2018, 30 November 2018.
423 UNHCR, Cross-Border Humanitarian Response Fact Sheet - Northwest Syria - December 2018, 31 December 2018; OCHA, Syrian Arab Republic: Overview of Humanitarian Response from within Syria (January - November 2018), 30 November 2018; Reach, Humanitarian Situation Overview in Syria (HSOS): Northeast Syria, November 2018, 30 November 2018; ACLED, The risks of reconciliation: civilians and former fighters face continued threats in Syria, 25 January 2019.
424 In January 2018, an estimated 151,000 people were driven from their homes in the Afrin region during the military Operation Olive Branch. Most of them were given shelter in Tal Refaat, Nubul, Zahra and Fafin in the province of Aleppo. UNHCR, Syria Factsheet (January - November 2018), 31 December 2018.
425 The lack of financial means alone prevented many displaced persons from returning to the area where they originally came from. Confidential source, 6 June 2019.
426 Confidential source, 6 June 2019.
427 OCHA, Syria: Situation Report 4: Recent Developments in Northwestern Syria, 31 May 2019.
428 Confidential source, 6 June 2019.
registered as refugees.429 In early March 2019, the UN announced that more
children had been killed in 2018 than in previous years. 1,016 children were killed in 2018.430
Food
Millions of Syrians in all 14 provinces of the country depend on food aid, which is provided by various organisations. Especially in areas which are under siege or hard to access, the stopping of food convoys is used by the Syrian authorities as a means of exerting political pressure. This regularly impedes timely and continuous delivery.
Starvation seems to have been used as a military tactic in the recapture of besieged areas by the Syrian authorities.431
It is estimated that one-third of the Syrian population has no food security. Chronic malnutrition is prevalent in some areas. Palestinian refugees in Syria in particular were still vulnerable to displacement, loss of property and the destruction of their neighbourhoods.432
Health care
After years of conflict, the quality of Syrian health care has seriously deteriorated.
Bombing by the Syrian and Russian armies has damaged hospitals and other medical facilities, putting them completely or partially out of action. Between 2011 and 2017, there were 492 attacks on hospitals and clinics, killing 847 health workers. In the first nine months of 2018, 97 people died and 165 were injured in attacks on medical facilities.433 Between the end of April and mid-May 2019, 19 medical facilities were bombed according to the Union of Medical Care and Relief Organizations-USA.434
In Idlib and eastern Ghouta in particular, medical centres were targeted in attacks by the Syrian authorities. In addition, there was a shortage of medical personnel, because medics had fled or been killed in the violence. Medical materials and medicines were also in short supply, especially in besieged areas. As a result, many children were not vaccinated.435
Some facilities in former opposition areas have been repaired, but have not been restored to pre-2010 levels. In most areas, facilities have not been repaired; in fact, more and more health facilities are being attacked, as is the case in Idlib.436
Education and health care have fallen far behind.437 The UN estimates that almost half of the health facilities are either closed or only partly functional, as a direct result of the hostilities. The protection of care providers and medical staff is a serious concern; dozens of aid workers have already been killed in 2019.438 Education
429 UNICEF Syria Crisis Situation Report - November 2018, 30 November 2018.
430 https://www.unicef.org/press-releases/2018-deadliest-year-yet-children-syria-war-enters-9th-year.
431 WFP, WFP Syria Situation Report #3, March 2019, 30 March 2019.
432 OCHA, 2019 Humanitarian Needs Overview: Syrian Arab Republic, 1 March 2019. WFP, Syria Situation Report #4, April 2019, 30 April 2019. See also https://hno-syria.org/#home.
433 SAMCF, Impacts of attacks on healthcare in Syria, 19 October 2018.
434 NPR, In Syria, Reports Of 19 Medical Facilities Bombed Since April 28, 17 May 2019.
435 SAMCF, Impacts of attacks on healthcare in Syria, 19 October 2018.
436 https://reliefweb.int/report/syrian-arab-republic/syrian-conflict-eight-years-devastation-and-destruction-health-system.
437 Confidential source, 24 March 2019.
438 OCHA, 2019 Humanitarian Needs Overview: Syrian Arab Republic, 1 March 2019.
The conflict has had a major impact on the percentage of school-going children.
Because many children have been displaced and a quarter of schools are not in use,439 many children are unable to attend primary or secondary education.440 In some opposition-controlled areas, the official Syrian curriculum is followed in schools, but without references to the Baath Party and Assad. However, in areas where a different curriculum is used, children run the risk of falling behind because the education they have followed and any certificates or diplomas obtained for it are not recognised by the Syrian authorities.441
There are hundreds of thousands of children in opposition areas in need of primary schooling. Their schools are shelled during attacks by government forces.442
Recapture of opposition areas
In July 2018, pro-government forces launched Operation Basalt to recapture southern Syria from the armed groups443 of the Southern Front.444 Large-scale bombing caused hundreds of thousands of Syrians to flee to the south-west, where they became stranded at the border with Jordan.445 Jordan had closed its border after a bomb attack in June 2016, and also stated that the country had already received 660,000 registered Syrian refugees and was unable to handle a new influx.
Previously, 50,000 Syrians had become stuck in the desert area on the Syrian-Jordanian border known as ‘the berm’.446 They found shelter in an informal displacement camp near Rukban, a remote hamlet close to the point where three countries’ borders meet in the desert, because Jordan would not let them in. In the Rukban camp, civilians live alongside fighters and criminal gangs are active.447 Tens of thousands of displaced persons also sought refuge on the border between the Syrian part and the Israeli-annexed part of the Golan Heights.448 In Israel, Prime Minister Netanyahu reiterated on 1 July 2018 that the country ‘will not allow access to our territory’. The Israeli army did, however, deliver aid packages to a limited extent across the border.449
439 Schools have been destroyed, there are no teaching staff, or school buildings are being used as shelters for displaced persons.
440 Unicef, UNICEF Syria Crisis Situation Report - April 2019 Humanitarian Results, 30 April 2019.
441 Borgenproject.org, Education in Syria Has Continued Despite Civil War, 8 February 2019.
442 One source reports that a 14-year-old child leaving school is an easy target for all radical groups. They give him a gun and 5,000 or 10,000 Syrian pounds, and once he has the gun in his hand his brain stops working.
Confidential source, 20 March 2019. See also Unicef, UNICEF Syria Crisis Situation Report - April 2019 Humanitarian Results, 30 April 2019.
443 For an enumeration of all these groups see Oxford Analytica, Damascus’s return to the south may feed future tension, 21 August 2018.
444 The Southern Front was an alliance established in February 2014 of more than 50 unstructured armed opposition groups associated with the Free Syrian Army. Its approximately 30,000 fighters were led by the Military Operations Command (MOC) in Jordan. BBC News, Syria war: Southern rebels see US as key to success, 9 December 2014; Carter Center, Syria – Countrywide Conflict Report No. 5, February 2015; Bellingcat, Syrian Opposition Factions in the Syrian Civil War, 13 August 2016; ICG, Middle East Report N°187 - Keeping the Calm in Southern Syria, 21 June 2018; OCHA, Syrian Arab Republic: Dara’a, Qunaitra, Sweida Flash Update No. 2, 2 July 2018; IRIN, UN fears new Syrian offensive could stand up to 200,000 civilians, 25 June 2018; OCHA, Syrian Arab Republic: Dar’a, Quneitra, As-Sweida - Situation Report No. 3, 19 July 2018. The Guardian, Syrian government forces seal victory in southern territories, 31 July 2018.
445 IRIN, UN fears new Syrian offensive could stand up to 200,000 civilians, 25 June 2018.
446 Ibid.
447 Ibid. Baresh, Manhal. The Sochi agreement and the interests of guarantor states: examining the aims and challenges of sustaining the deal. European University Institute, 2019
448 Most of them slept out in the open. The area where Israeli settlements are now was Syrian territory until the Six Day War in 1967. In 1974, Syria and Israel agreed on a ceasefire line, with a buffer zone that has had to be monitored by a UN force since then. Baresh, Manhal. The Sochi agreement and the interests of guarantor states:
examining the aims and challenges of sustaining the deal. European University Institute, 2019.
449 A number of victims of the bombing were also treated in Israeli hospitals. Israel has provided medical and other humanitarian support to Syrians in the border areas since 2013. Baresh, Manhal. The Sochi agreement and the interests of guarantor states: examining the aims and challenges of sustaining the deal. European University Institute, 2019. Oxford Analytica, Syrian reconstruction plans may block refugee return, 6 July 2018.
On 21 July 2018, the Israeli army brought hundreds of members of the Syria Civil Defence, also known as White Helmets450, from south-western Syria via Israel to Jordan.451
Despite the hostilities, UN and other humanitarian organisations provided tents, food, health care and education to hundreds of thousands of Syrians on the Jordanian border.452 In addition, organisations used mobile clinics to provide emergency psychological support to those who had fled the violence. Mobile teams also provided information to displaced persons about the risks of abandoned landmines.453 Many of those who had been displaced made their way to camps and villages in the province of Quneitra, near the Golan Heights.454 To this day,
humanitarian workers have virtually no access to this area.
Conditions on the Jordanian border were particularly harsh, with desert storms and temperatures of up to 45 degrees in the summer. Children and women died from the effects of polluted drinking water, dehydration and scorpion bites. Some seriously ill people were admitted to hospitals in Ramtha and Irbid in Jordan.455
The provision of humanitarian aid from Jordan was made harder by the poor security situation and was subject to political decisions. Food convoys sometimes faced long waits before they could cross the border at Ramtha.456 After the Nasib border crossing between Jordan and Syria was reopened, tens of thousands of displaced persons returned to their villages in early July 2019. However, more than 200,000 displaced persons remained in south-western Syria. At that point, they were dependent on food aid, which could no longer be delivered across the border via Jordan. From then on, aid was provided by the World Food Programme (WFP) and NGOs and distributed by the Syrian Arab Red Crescent (SARC), the Syrian branch of the International Federation of the Red Cross.457 NGOs from Amman and Damascus provided health care to displaced persons in the area in conjunction with the SARC and local authorities in Jordan and Syria.458 In addition to people living in the combat zone being forced to leave their homes, emergency workers also had to flee or ran out of supplies.459 NGOs asked the Syrian authorities for protection in order to continue working after the Syrian army had recaptured the areas.460
In most cases, permission was not given and NGOs, UN organisations and local aid workers were unable to gain humanitarian access in order to provide assistance.
This problem and the prolonged hostilities created food and fuel shortages, pushing up prices and making assistance more difficult.461
The provision of assistance by NGOs from Damascus encountered problems because the NGOs were refused the permits they needed to reach the displaced persons in
450 For details about the White Helmets see page 49.
451 Due to the rapid advance of the Syrian army in the south-western province of Dara’a, the rescue workers had nowhere to go. https://www.bbc.com/news/world-middle-east-44915099.
452 OCHA, Syrian Arab Republic: Dara’a, Qunaitra, Sweida Flash Update No. 2, 2 July 2018.
453 Ibid.
454 OCHA, Jordan | Syrian Arab Republic: Dara’a, Qunaitra, Sweida Flash Update No. 4, 2 July 2018.
455 Ibid.
456 Permission to cross had to be given by the Syrian authorities. OCHA, Jordan | Syrian Arab Republic: Dara’a, Qunaitra, Sweida Flash Update No. 4, 2 July 2018.
457 OCHA, Syrian Arab Republic: Dar’a, Quneitra, As-Sweida - Situation Report No. 2, 12 July 2018. See the website of the Syrian Arab Red Crescent: http://sarc.sy/.
458 OCHA, Syrian Arab Republic: Dar’a, Quneitra, As-Sweida - Situation Report No. 2, 12 July 2018.
459 Thousands of Syrians were earning USD 200 to 300 per month at clinics, schools, police units, local councils and NGOs up to the time of the retaking of this territory. Their salaries were paid by foreign donors. After the recapture, many lost their jobs and kept their past hidden from the security forces. ICG, Lessons from the Syrian State’s Return to the South - Middle East Report N°196, 25 February 2019.
460 OCHA, Syrian Arab Republic: Dar’a, Quneitra, As-Sweida - Situation Report No. 3, 19 July 2018.
461 Ibid.
the province of Quneitra. In many cases, permission was not granted either for carrying out needs assessments, or for actually providing and monitoring
assistance.462 Medicines were sent from Damascus to clinics in recaptured areas, albeit in drastically insufficient volumes.463 Legal aid teams from local NGOs,
supported by UNHCR, provided as much information as possible to displaced persons at various locations in the province of Dara’a about personal documents, especially identity cards and birth certificates.464 At the beginning of August 2018, the UN called for immediate access to the 184,000 displaced persons in the south-west.465 After the hostilities ended, most displaced persons in this area returned to their villages.466 Once the Syrian government had taken over the area, cross-border assistance from Jordan was no longer possible. Since then, aid has had to come from Syria, but in many cases humanitarian aid is still being seriously delayed or not allowed.467
North-western Syria
The large number of displaced persons in Idlib has put a lot of pressure on the limited assistance available in the area. Humanitarian organisations operate from Turkey to provide assistance in the area. Due to the constant unrest and insecurity, humanitarian organisations’ freedom of movement is limited. Heavy rains led to flooding at the end of October 2018, causing serious problems for around 400,000 IDPs in improvised tent camps. There are major humanitarian aid shortages in all sectors. One major problem is lack of space to accommodate people.468 Health care was the main priority in the north and west of Aleppo province. Many residents found it difficult or impossible to go to hospitals or clinics due to lack of transport or the high cost of it.469 The food supply was the main priority in Idlib. According to the World Food Programme, 6.5 million Syrians, many of whom live in Idlib, suffer from an acute shortage of food.470
The NGO REACH Initiative conducts a monthly survey of the humanitarian situation in Syria in terms of displacement, shelter, health care, water supply and hygiene, food safety, income and education. For the November 2018 fact sheet on north-western Syria, Reach collected information in 840 locations in the provinces of Idlib (262), northern and western Aleppo (482), Hama (92) and Homs (4).471
In November 2018, UNHCR and partner agencies provided assistance to displaced persons and host families in 261 towns and villages in 51 sub-districts in the provinces of Idlib, Aleppo, Hama, Deir al-Zor and Hasaka. The assistance consisted of socio-psychological support, tracing of family members and family reunification, combating sexual violence and exploitation of children and providing information about documents. UNHCR is one of the smaller care providers in the north-west;
NGOs such as the NRC, WVI, Warchild, Mercy Corps and UN organisations have far greater capacity.472 See also 4.3
462 OCHA, Syrian Arab Republic: Dara’a, Quneitra, Sweida - Situation Report No. 4, 29 July 2018. OCHA, Syrian Arab Republic: Dar’a, Qunaitra, Sweida - Situation Report No. 5, 3 August 2018.
463 OCHA, Syrian Arab Republic: Dara’a, Quneitra, Sweida - Situation Report No. 4, 29 July 2018.
464 Ibid.
465 OCHA, Syrian Arab Republic: Dar’a, Qunaitra, Sweida - Situation Report No. 5, 3 August 2018.
466 Confidential source, 27 March 2019.
467 Confidential source, 31 May 2019.
468 Reach, Humanitarian Situation Overview in Syria (HSOS): Northwest Syria, October 2018, 31 October 2018. See also Unicef, In northern Aleppo’s Fafin camp in Syria, families prepare for winter, 6 January 2019; UNHCR, Syria Refugee Response: Informal Settlements - Flood Risks in the coming 72 hours, 8 January 2019; ICG, Lessons from the Syrian State’s Return to the South - Middle East Report N°196, 25 February 2019.
469 Reach, Humanitarian Situation Overview in Syria (HSOS): Northwest Syria, October 2018, 31 October 2018.
470 Ibid. https://www1.wfp.org/countries/syrian-arab-republic.
471 Reach, Humanitarian Situation Overview in Syria (HSOS): Northwest Syria, October 2018, 31 October 2018.
472 UNHCR, Syria Protection Cluster (Turkey): Response Snapshot (as of 30 November 2018), 20 December 2018.